Cost-effectiveness analysis of house dust mite allergen immunotherapy in children with allergic asthma

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • André Miguel Afonso De Sousa Moreira

    Autor

Participantes de fora da FMUP

  • Farraia, M
  • Paciência, I
  • Mendes, FC
  • Rufo, JC
  • Shamji, MH
  • Agache, I

Unidades de investigação

Abstract

Background Cost-effectiveness studies evaluating allergen immunotherapy (AIT) in children are limited but needed to drive clinical and policy-making decisions such as reimbursement of new interventions. In this study, we compared the cost effectiveness of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) tablets to the standard of care (SOC) treatment in children with house dust mite-driven (HDM) allergic asthma. Methods We developed a hypothetical Markov model based on the Global Initiative for Asthma (GINA) severity steps to compare the three strategies over a 10-year horizon divided by cycles of 6 months. SOC was used as a reference to calculate the incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses were used to assess models' uncertainty. Other scenarios were evaluated to strengthen the presentation of results. Results The ICER for SCIT and SLIT tablets was 1281euro and 7717euro, respectively. The cost-effectiveness threshold for Portugal was 1,848,280euro; both treatment approaches were below this limit. The major contributors to these results were the AIT effects on reducing moderate and severe exacerbations and asthma controller medication. In the sensitivity analysis, SCIT revealed a higher probability of cost-effectiveness than SLIT. When including allergic rhinitis as comorbidity, ICER values reduced markedly, especially for SCIT intervention. Conclusions AIT was cost effective in children with HDM-driven allergic asthma, especially when given by the subcutaneous route. The high probability of cost effectiveness, especially for SCIT, may drive future policy decisions and AIT-prescribing habits. AIT adherence greatly influenced the results highlighting the value of implementing strategies to promote adherence rates.

Dados da publicação

ISSN/ISSNe:
0105-4538, 1398-9995

ALLERGY  Wiley-Blackwell Publishing Ltd

Tipo:
Article
Páginas:
2688-2698
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 4

Citações Recebidas na Scopus: 10

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Keywords

  • allergen immunotherapy; asthma; children; cost effectiveness; house dust mites

Financiamento

Proyectos asociados

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Investigador Principal: André Miguel Afonso de Sousa Moreira

Estudo Clínico Académico (Aeroallergens) . 2020

Eosinophil cationic protein (ECP) correlates with eosinophil cell counts in the induced sputum of elite swimmers

Investigador Principal: André Miguel Afonso de Sousa Moreira

Estudo Clínico Académico (ECP) . 2021

How exercise, physical activity and diet modulate immune and stress responses

Investigador Principal: André Miguel Afonso de Sousa Moreira

Estudo Clínico Académico . 2020

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